Møller Sidsel, Wissenberg Mads, Kragholm Kristian, Folke Fredrik, Hansen Carolina Malta, Ringgren Kristian B, Andersen Julie, Barcella Carlo, Lippert Freddy, Køber Lars, Gislason Gunnar, Gerds Thomas Alexander, Torp-Pedersen Christian
Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; Copenhagen Emergency Medical Services, University of Copenhagen, Denmark.
Resuscitation. 2020 Aug;153:10-19. doi: 10.1016/j.resuscitation.2020.05.022. Epub 2020 May 22.
It remains unclear whether socioeconomic differences exist in post-resuscitation care in out-of-hospital cardiac arrests (OHCA). We aimed to examine socioeconomic differences in coronary procedures and survival after OHCA.
OHCA patients ≥30 years of cardiac cause with a hospital admission from the Danish Cardiac Arrest Registry, 2001-2014, were divided according to quartiles of household income (lowest, low, high, highest). Associations of income, coronary procedures and 30-day survival were examined by age-standardized incidence rates and incidence rate ratios (IRR), and by logistic regression.
A total of 6105 patients were included. Higher-income patients were younger, males and had less comorbidity-burden. Higher-income patients had higher incidence rates for coronary angiographies both day 0-1 and day 2-7 after OHCA (day 0-1: highest: IRR 1.79, 95%CI 1.46-2.21; high: IRR 1.28, 95%CI 1.10-1.51; low: IRR 1.05, 95%CI 0.90-1.23), compared to lowest. Fifty-four percentage of the patients undergoing a coronary angiography received percutaneous-coronary-intervention or coronary-artery-bypass-grafting with no difference among three of the four groups, but lower IRR in low-income patients (IRR 0.74, 95%CI 0.61-0.89) compared to lowest. Higher-income patients had also higher odds for 30-day survival compared to lowest, both in patients with (highest: OR 1.61, 95%CI 1.12-2.32; high: OR 1.13, 95%CI 0.80-1.60; low: OR 1.14, 95%CI 0.81-1.61) and without (highest: OR 2.54, 95%CI 1.83-3.53; high: OR 1.41, 95%CI 1.06-1.87; low: OR 1.12, 95%CI 0.86-1.47) coronary angiography day 0-1.
Higher-income patients were found associated with more performed coronary angiographies after OHCA, and higher odds for 30-day survival.
院外心脏骤停（OHCA）复苏后护理中是否存在社会经济差异仍不明确。我们旨在研究OHCA后冠状动脉手术和生存率方面的社会经济差异。
将2001年至2014年丹麦心脏骤停登记处收治的≥30岁心脏病因的OHCA患者，根据家庭收入四分位数（最低、低、高、最高）进行分组。通过年龄标准化发病率和发病率比（IRR）以及逻辑回归分析来研究收入、冠状动脉手术和30天生存率之间的关联。
共纳入6105例患者。高收入患者更年轻，男性居多，合并症负担较轻。OHCA后第零天至第一天和第二天至第七天，高收入患者冠状动脉造影的发病率均高于低收入患者（第零天至第一天：最高组：IRR 1.79，95%CI 1.46 - 2.21；高收入组：IRR 1.28，95%CI 1.10 - 1.51；低收入组：IRR 1.05，95%CI 0.90 - 1.23）。接受冠状动脉造影的患者中有54%接受了经皮冠状动脉介入治疗或冠状动脉搭桥术，四组中的三组之间无差异，但低收入患者的发病率比低于最低收入组（IRR 0.74，95%CI 0.61 - 0.89）。无论在第零天至第一天接受冠状动脉造影的患者（最高组：OR 1.61，95%CI 1.12 - 2.32；高收入组：OR 1.13，95%CI 0.80 - 1.60；低收入组：OR
